NCLEX: Management of Care Practice Exam,

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NCLEX: Management of Care Practice Exam,

NCLEX Review - Management of Care All Possible Exam Questions and Correct Detailed Answers/ Graded A+

The healthcare provider is caring for a patient who has septic shock. Which of these should the healthcare provider administer to the patient first?

• Vasopressors to increase blood pressure
• Corticosteroids to reduce inflammation
• IV fluids to increase vascular volume
• Antibiotics to treat the underlying condition - Correct Answer - c. IV fluids to increase

vascular volume

A nurse is taking care of a previously healthy adult patient with a newly diagnosed serious medical condition. The patient is apprehensive and confused by all of the information, tests, test results, and the number of medical practitioners involved in the care plan. The nurse knows that it is her job to inform and educate this patient on the rights and responsibilities of those receiving healthcare as specified in the Patients' Bill of Rights. According to this document, which of the following is not included in this discussion?

• the right to choose any provider or plan for healthcare
• the responsibility to inform the healthcare staff of any previous conditions and

medications

• the right to refuse any treatment
• the right to be informed about and participate in the decisions regarding medical

treatment - Correct Answer - c. the right to refuse any treatment (this is part of the Patient Self-Determination Act)

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pg. 2 The nurse working in the ICU takes a phone call from an unknown person inquiring about the status of one of the patients under her care. Which of the following is the best course of action for the nurse?

• Tell the person that the information cannot be given over the phone.
• Take all of the caller's information and list it in the patient's chart prior to sharing the

requested information.

• Tell the person the patient's condition and reassure them the best care is being given.
• Check the patient's chart to see if the person is listed to receive confidential

information about the patient's medical condition and care. - Correct Answer - d. Check the patient's chart to see if the person is listed to receive confidential information about the patient's medical condition and care.

In which of these situations is a nurse in violation of HIPAA guidelines?

• The nurse has a conversation about a patient's change in status with the nurse that's

about to take over care in earshot of a nurse's aide who is not assigned to that patient.

• The nurse forgets to close out a patient's electronic medical record and leaves the

information on the monitor where it can be read by other patients and visitors.

• The nurse jots a patient's name and vitals on a scrap piece of paper rather than

directly into the medical record, but shreds it after the information has been recorded.

• The nurse has a conversation with a patient about the results of his labs and other

diagnostic tests with the patient's wife present in the room. - Correct Answer - b. The nurse forgets to close out a patient's electronic medical record and leaves the information on the monitor where it can be read by other patients and visitors.

The registered nurse (RN) has just accepted a position as a public health nurse. Which question might be the most relevant as the nurse begins employment?

1) "Which physicians will I be more closely collaborating with?" 2) "Which groups are at the greatest risk for problems?" 3) "Which clients should I see as I begin my day?" 4) "Which nursing assistants can I refer clients to?" - Correct Answer - 2

Rationale: 2 / 4

pg. 3 Public health nursing is focused on improving the health status of the entire community.Although all the options are good to know, it is most important that the RN understands which groups in the community have the greatest health needs. Public health nurses collaborate with physicians, as well as with other health care providers, to assess and prioritize major health problems in the community. They also assist individuals and families to take action to improve their health status. Nursing assistants provide care for individual clients and families, but this question is more appropriate for a visiting or home health nurse.

A Bosnian Muslim woman who does not speak English seeks care at a community clinic. Through physical gestures, the woman indicates that she has pain originating in either the pelvic or genital region. Assuming several people are available to interpret, who would be the most appropriate choice?

1) A female neighbor of the client who is also from Bosnia 2) A female interpreter who does not know the client 3) The client's adult daughter

4) A Bosnian male, who is a certified medical interpreter - Correct Answer - 2

Rationale:

When the nurse and the client do not speak the same language, or have limited fluency, the services of an interpreter are needed. But it may be inappropriate to have a male interpreter for a female client because the client may not be as forthcoming. The client may also feel it is inappropriate to have private matters interpreted by her daughter (especially if they are of a sexual nature or involve infidelity). To avoid a breach of confidentiality, the nurse should avoid using an interpreter from the same community as the client. The best response is to have a female interpreter who does not know the client.

The nurse observes a student nurse inserting an indwelling urinary catheter for a female client. After the student inserts the catheter, no urine appears and the student begins to remove the catheter. What should the nurse do at this time?

1) State strongly: "Stop. Tell me why there's no urine in the tubing." 3 / 4

pg. 4 2) Walk up and whisper in the student's ear: "Stop. Leave the catheter in place. I'll get a new sterile catheter." 3) In a speaking tone of voice, explain: "The tubing is probably in the vagina." 4) Ask the student in a calm voice: "Did you do something wrong?" - Correct Answer - 2

Rationale:

When no urine appears after inserting a catheter into a female client, the catheter may be in the vagina. This catheter can be left in place and used as a landmark indicating where not to insert the new, sterile catheter. The best approach is for the nurse is to calmly remind the student about this technique and offer assistance. The other options are unprofessional and/or they may upset the client and the student.

The nurse receives an order for a medication from the hospitalist. Knowing the drug is contraindicated for the client, the nurse twice verbalizes concerns about the contraindication to the hospitalist, who does not change the order. What action should the nurse take next?

1) Ask another staff nurse to discuss the same concerns with the hospitalist 2) Request a consult with the in-house pharmacist 3) Page the attending physician to express the same concerns 4) Administer the medication as ordered - Correct Answer - 3

Rationale:

The scenario is an example of the "two-challenge rule." It is the nurse's responsibility to assertively voice concerns at least two times to ensure that it has been heard. If the outcome is still not acceptable, the nurse needs to take a stronger course of action by either contacting a supervisor or the attending physician to express the same concerns.The nurse must be an advocate for the client.

A 90-year-old is readmitted to the hospital, less than 2 weeks after being discharged, for the same health concern. What factors contribute to hospital readmissions among older adults? (Select all that apply.)

1) Reconciliation of medications 2) Poor communication among providers

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